Medicaid: Half of Doctors Won’t Accept New Patients

Joshua de Gastyne /
May 08, 2014

Photo: Odilon Dimier/Getty Images

Merritt-Hawkins, a national health care search and consulting firm, recently released the results of a telephone survey that measures physicians’ ability or willingness to accept new Medicaid patients across five specialties in 15 metropolitan markets.

The survey’s key finding: The average rate of Medicaid acceptance by physicians in all five specialties and in all 15 markets surveyed was only 45.7 percent. This is lower than the acceptance rate found by the same survey in 2009 (55.4 percent) and in 2004 (49.9 percent).

The survey found that, in 2013, Boston had the highest rate of Medicaid acceptance by physicians in the 15 markets surveyed—73 percent—while Dallas had the lowest, a mere 23 percent.

Why do Medicaid patients face such barriers to accessing care? As the survey’s authors explain:

The rate at which physicians accept Medicaid can vary for a number of reasons. In some cases, reimbursement rates provided by Medicaid to particular specialists may be below their cost of providing services. If not actually below costs, Medicaid reimbursement often is relatively low compared to that offered by other payers, and therefore busy physicians may have no economic incentive to see Medicaid patients. In other cases, the process of billing for and receiving Medicaid payment can be problematic and some physicians choose to avoid it.

Medicaid patients’ difficulty accessing care is well-documented and has a long history. Despite these existing issues, one of the major ways Obamacare expands coverage is through the Medicaid program. The Congressional Budget Office projects that 7 million additional people will be added to the program in 2014. But having health coverage doesn’t necessarily mean these beneficiaries will be able to access health care. As Heritage Foundation policy analyst Kevin Dayaratna explains:

By further expanding this broken program, Obamacare will only exacerbate the situation, continuing to harm many low-income Americans who have no option other than Medicaid. Policymakers should reform Medicaid to allow Medicaid patients access to private insurance in a consumer-driven market.

Joshua de Gastyne is currently a member of the Young Leaders Program at The Heritage Foundation. For more information on interning at Heritage, pleaseclick here.